EAST-NOGA study

The First Prospective, Multicenter Study of Non-obstructive General Angioscopy for Aorta

 

Kojima K, Komatsu S, Kakuta T, Fukamachi D, Kimura S, Fujii H, Matsuura M, Dai K, Matsuoka H, Higuchi Y, Ueda Y, Asakura M, Yutani C, Okumura Y, Eikelboom JW, Hirayama A, Kodama K; EAST-NOGA study group. Aortic plaque burden predicts vascular events in patients with cardiovascular disease: The EAST-NOGA study. J Cardiol. 2022 Jan;79(1):144-152.

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“Evaluation of AtheroScleroTic and rupture events by Non-Obstructive General Angioscopy (EAST-NOGA),” is a prospective cohort study that aimed to investigate the association between the number of aortic plaques detected by Non-obstructive General Angioscopy (NOGA) and the risk of subsequent cardiovascular events.
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Patient Demographics: The study included 577 patients who underwent NOGA, and 532 of them completed the follow-up period, which had a median duration of 13 months (interquartile range: 12-16). The majority of patients had at least one aortic plaque, with a median number of plaques per person being 6 (interquartile range: 3-12).

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Primary Composite Endpoint: During the 13-month follow-up period, 38 patients (7.1%) experienced a primary composite endpoint. This composite endpoint included cardiovascular death, myocardial infarction, stroke, peripheral artery disease (PAD), or worsening renal function.

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Factors Associated with Composite Endpoint: The study found that several factors were significantly associated with the occurrence of the composite endpoint. These factors included chronic kidney disease, a history of PAD, a lower hemoglobin level, and a larger number of aortic plaques. Specifically, patients with 11 or more aortic plaques had a significantly higher risk of experiencing the composite endpoint compared to those with fewer plaques (11 [5-17] vs. 6 [2-11], p = 0.003).

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Multivariate Analysis: After adjusting for various confounding factors through multivariate analysis, the presence of 12 or more aortic plaques remained a significant predictor for composite endpoint events. Patients with 12 or more aortic plaques had a hazard ratio of 2.53 (95% confidence interval 1.26-5.04, p = 0.010) for experiencing the composite endpoint events.

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The study concludes that the number of aortic plaques detected by NOGA can serve as a predictive factor for subsequent cardiovascular events. Specifically, patients with 12 or more aortic plaques had a significantly higher risk of experiencing events such as cardiovascular death, myocardial infarction, stroke, PAD, or worsening renal function during the follow-up period.

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In summary, this study suggests that NOGA may be a valuable tool in assessing the risk of cardiovascular events by quantifying the number of aortic plaques. Patients with a higher burden of aortic plaques, specifically 12 or more, may benefit from closer monitoring and preventive measures to reduce their risk of adverse cardiovascular outcomes.